High prevalence of TB disease in contacts of adults with extrapulmonary TB

Wingfield, T., MacPherson, P. , Cleary, P. and Ormerod, L. P. (2018) High prevalence of TB disease in contacts of adults with extrapulmonary TB. Thorax, 73(8), pp. 785-787. (doi: 10.1136/thoraxjnl-2017-210202) (PMID:29146867) (PMCID:PMC6204960)

Abstract

UK guidelines no longer recommend routine screening of household contacts of adult patients with extrapulmonary TB (EPTB). From 27 March 2012 to 28 June 2016, we investigated the prevalence of active TB disease in household contacts of 1023 EPTB index cases in North West England, and compared estimates with: published new entrant migrant screening programme prevalence (~147/100 000 person-years); London-based contact screening data (700/100 000 contacts screened); and National Institute for Health and Care Excellence (NICE) new entrant TB screening thresholds (TB prevalence >40/100 000 people). Active TB disease prevalence in EPTB contacts was 440/100 000 contacts screened, similar to UK new entrant screening programmes, London EPTB contact prevalence and >10 times NICE's threshold for new entrant screening. The decision to no longer recommend routine screening of EPTB contacts should be re-evaluated and cost-effectiveness analyses of screening strategies for EPTB contacts should be performed.

• Item Type: Articles
• Additional Information: TW is supported by grants from the Wellcome Trust (Grant: 209075/Z/17/Z), the Academy of Medical Sciences (JXR12769), the Liverpool Glasgow Wellcome Trust Centre for Global Health Research, the University of Liverpool, and the National Institute for Health Research. PM is supported by the Wellcome Trust (Grant: 206575/Z/17/Z).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacPherson, Professor Peter
• Authors: Wingfield, T., MacPherson, P., Cleary, P., and Ormerod, L. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Thorax
• Publisher: BMJ Publishing Group
• ISSN: 0040-6376
• ISSN (Online): 1468-3296
• Published Online: 16 November 2017
• Copyright Holders: Copyright © The Author(s) 2018
• First Published: First published in Thorax 73(8):785-787
• Publisher Policy: Reproduced under a Creative Commons licence